## Commonly used forms ### Cancel form for employees or dependents [Download form](https://bluecrossmn.widen.net/content/sa54nosf2i/original/f8708r11-0321-fillable-508.pdf) ### COBRA Forms and information [Search forms](https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/cobra#employers) ### Electronic funds transfer form [Download form](https://bluecrossmn.widen.net/content/lwbrw4fhz2/original/electronic-funds-transfer-f10608r07.pdf) ### Employer portal access request form [Download form](https://bluecrossmn.widen.net/content/pjbmzc3xay/original/employer-portal-access-form_2.1.2021.pdf) ### Employer portal access request form — Small group [Download form](https://bluecrossmn.widen.net/content/09pvxs1ucn/original/20210503-small-goup-employer-portal-request-form.pdf) ### Group plan enrollment/waiver form — 2026 [Download form](https://bluecrossmn.widen.net/content/pe48dgh4hm/original/2026-group-plan-enrollment-waiver-form-f10936r07-508c.pdf) ### Small group change form [Download form](https://bluecrossmn.widen.net/content/gn9vrejfk0/original/2022-small-group-change-form-f7142r18.pdf) Administer your company’s health benefits with these forms and benefit administration guides. ### Small group ### 2026 [2026 Small group business application](https://bluecrossmn.widen.net/content/yg8jkfcxqh/original/2026-small-group-business-application-f10538r10-508c.pdf "2026-small-group-business-application-f10538r10-508c.pdf") [2026 Enrollment/waiver form — English](https://bluecrossmn.widen.net/content/pe48dgh4hm/original/2026-group-plan-enrollment-waiver-form-f10936r07-508c.pdf "2026-group-plan-enrollment-waiver-form-f10936r07-508c.pdf") [2026 Enrollment/waiver form — Spanish](https://bluecrossmn.widen.net/content/om6jh8wv8y/original/2026-group-plan-enrollment-waiver-form-spanish-f10936r07b.pdf "2026-group-plan-enrollment-waiver-form-spanish-f10936r07b.pdf") ### 2025 [2025 Small group business application](https://bluecrossmn.widen.net/content/buzabg9hui/original/2025-small-group-business-application.pdf "2025-small-group-business-application.pdf") [2025 Enrollment/waiver form — English](https://bluecrossmn.widen.net/content/rqlxwnffxg/original/2025-group-plan-enrollment-waiver-form-f10936r06-508.pdf "2025-group-plan-enrollment-waiver-form-f10936r06-508.pdf") [2025 Enrollment/waiver form — Spanish](https://bluecrossmn.widen.net/content/gttaq7gn5l/original/2025-group-plan-enrollment-waiver-form-spanish-f10936r06b-508.pdf "2025-group-plan-enrollment-waiver-form-spanish-f10936r06b-508.pdf") ### General [Access plan documents such as benefit summaries, benefit booklets and SBCs](/understanding-health-insurance/commercial-plan-documents "Commercial plan documents") [Authorization for disclosure of health information — Online form](/member-resources/authorization-disclosure-health-information "Authorization for Disclosure of Health Information") [Authorization for disclosure of health information — English](https://bluecrossmn.widen.net/content/1huigrqfub/original/authorization-for-disclosure-of-health-information.pdf "authorization-for-disclosure-of-health-information.pdf") [Authorization for disclosure of health information — Hmong](https://bluecrossmn.widen.net/content/xcdmovewej/original/x21006cr10_1121_hmong.pdf "x21006cr10_1121_hmong.pdf") [Authorization for disclosure of health information — Spanish](https://bluecrossmn.widen.net/content/acevqbr0ee/original/adhi_form_spanish.pdf "adhi_form_spanish.pdf") [Cancel form for employees or dependents](https://bluecrossmn.widen.net/content/sa54nosf2i/original/f8708r11-0321-fillable-508.pdf "f8708r11-0321-fillable-508.pdf") [Small group change form](https://bluecrossmn.widen.net/content/gn9vrejfk0/original/2022-small-group-change-form-f7142r18.pdf "2022-small-group-change-form-f7142r18.pdf") [HIPAA special enrollment notice](https://bluecrossmn.widen.net/content/lesqpkedcy/original/p11ga_13556942-f8381r02_508_hipaa-special-enrollment-notice.pdf "p11ga_13556942-f8381r02_508_hipaa-special-enrollment-notice.pdf") [Subscriber claim form](https://bluecrossmn.widen.net/content/fdhrvwvdeq/original/member-claim-form-f7403r13-web.pdf "member-claim-form-f7403r13-web.pdf") ### Large group [Large group HIPAA special enrollment notice](https://bluecrossmn.widen.net/content/wvn97uwghg/original/p11ga_13557021-large-group-hipaa-special-enroll.pdf "p11ga_13557021-large-group-hipaa-special-enroll.pdf") [2026 Enrollment/waiver form — English](https://bluecrossmn.widen.net/content/pe48dgh4hm/original/2026-group-plan-enrollment-waiver-form-f10936r07-508c.pdf "2026-group-plan-enrollment-waiver-form-f10936r07-508c.pdf") [2026 Enrollment/waiver form — Spanish](https://bluecrossmn.widen.net/content/om6jh8wv8y/original/2026-group-plan-enrollment-waiver-form-spanish-f10936r07b.pdf "2026-group-plan-enrollment-waiver-form-spanish-f10936r07b.pdf") [2025 Enrollment/waiver form — English](https://bluecrossmn.widen.net/content/rqlxwnffxg/original/2025-group-plan-enrollment-waiver-form-f10936r06-508.pdf "2025-group-plan-enrollment-waiver-form-f10936r06-508.pdf") [2025 Enrollment/waiver form — Spanish](https://bluecrossmn.widen.net/content/gttaq7gn5l/original/2025-group-plan-enrollment-waiver-form-spanish-f10936r06b-508.pdf "2025-group-plan-enrollment-waiver-form-spanish-f10936r06b-508.pdf") [Large group cancelation form — English](https://bluecrossmn.widen.net/content/sa54nosf2i/original/f8708r11-0321-fillable-508.pdf "f8708r11-0321-fillable-508.pdf") [Large group cancelation form — Spanish](https://bluecrossmn.widen.net/content/j0mhaawggx/original/p11ga_23031897-f8708r10b_esus_web.pdf "p11ga_23031897-f8708r10b_esus_web.pdf") ### Group Medicare [Medicare Part D creditable letter](https://bluecrossmn.widen.net/content/azebak7ttc/original/p11ga_13557174-p11ga_13557174-1.pdf "p11ga_13557174-p11ga_13557174-1.pdf") [Medicare Part D non-creditable letter](https://bluecrossmn.widen.net/content/hklt3weqao/original/p11ga_13557179-p11ga_13557179-2.pdf "p11ga_13557179-p11ga_13557179-2.pdf") ### Other forms [Authorization for disclosure of health information — Online form](/member-resources/authorization-disclosure-health-information "Authorization for Disclosure of Health Information") [Authorization for disclosure of health information — English](https://bluecrossmn.widen.net/content/1huigrqfub/original/authorization-for-disclosure-of-health-information.pdf "authorization-for-disclosure-of-health-information.pdf") [Authorization for disclosure of health information — Hmong](https://bluecrossmn.widen.net/content/xcdmovewej/original/x21006cr10_1121_hmong.pdf "x21006cr10_1121_hmong.pdf") [Authorization for disclosure of health information — Spanish](https://bluecrossmn.widen.net/content/acevqbr0ee/original/adhi_form_spanish.pdf "adhi_form_spanish.pdf") [Fully insured plan election form (2026)](https://bluecrossmn.widen.net/content/simgh1yab4/original/2026-fully-insured-plan-election-form-x20825r11.pdf "2026-fully-insured-plan-election-form-x20825r11.pdf") [Fully insured plan election form (2025)](https://bluecrossmn.widen.net/content/8qp6m4eeff/original/2025-fully-insured-plan-election-form-x20825r09.pdf "2025-fully-insured-plan-election-form-x20825r09.pdf") [Self-insured plan election form (2026)](https://bluecrossmn.widen.net/content/txb8uy2kyp/original/2026-self-insured-plan-election-form-x20824r10.pdf "2026-self-insured-plan-election-form-x20824r10.pdf") [Self-insured plan election form (2025)](https://bluecrossmn.widen.net/content/k9sgl1dxr2/original/2025-self-insured-plan-election-form-x20824r09.pdf "2025-self-insured-plan-election-form-x20824r09.pdf") [Retiree-only group attestation form (2026)](https://bluecrossmn.widen.net/content/0clsbo4tom/original/2026-retiree-attestation-x20827r10.pdf "2026-retiree-attestation-x20827r10.pdf") [Retiree-only group attestation form (2025)](https://bluecrossmn.widen.net/content/povg7msxxq/original/2025-retiree-only-group-attestation-x20827r09.pdf "2025-retiree-only-group-attestation-x20827r09.pdf") [Grandfathered plan notice](https://bluecrossmn.widen.net/content/v0qxpuj8jj/original/p11ga_13557486-grandfathered-1.pdf "p11ga_13557486-grandfathered-1.pdf") [MA HCR filing service](https://bluecrossmn.widen.net/content/7kysdxeyce/original/mass-health-care-reform-attest-m06667.pdf "mass-health-care-reform-attest-m06667.pdf") [Premium contribution tool (XLS)](https://bluecrossmn.widen.net/content/bzy2joddom/original/p11ga_13557527-mbc1_emp_premium_tool.xls "p11ga_13557527-mbc1_emp_premium_tool.xls") - Only for fully insured groups, to determine grandfathered status ### Log in to Connect Access insights, analytics, training materials and other resources with Connect. [Blue Cross Connect](https://connect.bluecrossmn.com/) ### Employer reporting solution guide Explore the latest news, training information and helpful resources to enhance your understanding of our employer reporting solution. [Employer reporting solution guide](/employers/employer-documents-forms/employer-reporting-solution-guide)